Objective To investigate the effect of dexmedetomidine combined with ulinastatin on postoperative delirium in elderly patients undergoing resection of gastrointestinal tumor. Methods A total of 180 elderly patients (97 males,83 females,aged 65-80 years,ASA grade Ⅱ orⅢ)who underwent laparoscopic surgery for gastrointestinal tumor,were randomized into four groups (n =45 each):dexmedetomidine group (group D),ulinastatin group (group U),dexmedetomidine+ulinastatin group (group DU)and control group (group C).Patients in group D were given a loading dosage of dexmedetomidine 0.5 μg/kg intravenously 1 5 min before the induction of general anesthesia,followed by a continuous infusion of 0.3 μg·kg-1 ·h-1 ,and dexmedetomidine was ad-ministered till 40 min before the end of surgery.Patients in the group U were given a loading dosage of ulinastatin 10 000 U/kg intravenously in 20 min.In group DU,dexmedetomidine and ulinastatin were administered in accordance in group D and group U respectively.Patients in group C were given 0.9% saline solution.The volume of blood loss,the time of operation and recovery,the adverse reac-tions after surgery were recorded.The concentration of dopamine (DA),adrenaline (AD),norepi-nephrine (NE)were measured within the preoperative 1 d (T0 ),within the first hour of surgery (T1 ),within the postoperative 1 d (T2 ),2 d (T3 ),3 d (T4 ).The confusion assessment method Chi-nese reversion (CAM-CR)was used to screen POD on T0 ,T2-T4 .Results The levels of DA,AD and NE in the group C and group U at T1-T4 significantly elevated than those at T0 (P <0.05);the levels of DA at T1 and the levels of AD at T1 ,T2 in group D and group DU significantly elevated than those at T0 (P <0.05).The levels of DA,AD at T3 ,T4 and the levels of NE at T1-T4 in group D and group DU were significantly reduced compared with those in the group C and group D (P <0.05 ). Compared with the group C,the incidence of POD was significantly reduced in the group D,group U and group DU (P <0.05).Among the three groups (D,U and DU),the difference were not statisti-cally significant in the incidence of POD.Conclusion Dexmedetomidine or ulinastatin may reduce the rate of POD in elderly patients undergoing laparoscopic surgery for gastrointestinal tumor.Compared with the administration of ulinastatin or dexmedetomidine alone,combined application of dexmedeto-midine and ulinastatin does not reduce the incidence of POD.

Objective To explore the effect of one-piece shoulder pillow on patients suffering from shoulder pain and skin erubescence during gynecological laparoscopy with lithotomy position and trendelenburg position. Methods Two hundred and six patients who underwent gynecological laparoscopic operation were divided into control and experiment groups according to cardinal or even number of registration. The patients in both groups were set in lithotomy position and trendelenburg position during the operation, with the difference in the use of a common shoulder pillow for support in the control group but no use in the experiment one. On-position time and incidence rate of shoulder pain and skin erubescence were compared between two groups. Result The sholder pain and skin erubescence were less than those of control group (P < 0.05). Conclusion Use of one-piece shoulder pillow can reduce the incidence rates of shoulder pain and skin erubescence after gynecological laparoscopic operation with lithotomy position and trendelenburg position.

BACKGROUND:Recently, electrospun materials have been extensively applied in the drug delivery system. OBJECTIVE:To overview the application prospect of electrospun materials in drug delivery systems. METHODS:A computer-based search of PubMed and NCBI databases was performed for literatures about the research progress of electrospinning in tissue engineering and chemotherapy published within the past 10 years using the keywords of“electrospinning, drug delivery system, nanofibers, electrospun materials”.RESULTS AND CONCLUSION:Compared with traditional materials, electrospun stents hold good versatility and control able parameters, thus granting its unique advantage under various physiological conditions. Current drug-loaded materials composed of natural products, synthetic polymers and blended materials;as to drugs, there are antibiotics, chemotherapy medication, DNA and protein. Electrospun materials have been used in tissue engineering, cancer chemotherapy and wound healing. We focus on not only the application progress of electrospun materials in traditional treatments, but also its usage, condition-control ed drug release and living-cel carrying. Electrospun materials combined with various drug-loaded present a broad prospect.

Objective To evaluate the internal reliability of Psychosocial Function Evaluation for mental disabled people in day care unit. Methods 16 participants were evaluated twice by the same rater (social worker) in the unit at the Permanent stage and the Steering stage. Results Cronbach's α was greater than 0.7 in the both evaluation. The Spearman correlation coefficient between each dimension and total score were between 0.502 and 0.869. Conclusion The internal reliability of Psychosocial Function Evaluation is satisfactory for mental disabilities.

Objective: Colorectal cancer (CRC) is one of the most common cancers and the major cause of cancer death in China. The aim of this study was to estimate the burden of CRC in China. Materials and methods: Data from the National Cancer Center (NCC) of China was used and stratified by area (urban/rural), sex (male/female) for analyzing the age-specific incidence and mortality rates. Time trend of colorectal cancer was calculated based on the 22 high-quality cancer registries in China. National new cases and deaths of colorectal cancer were estimated using age-specific rates multiplied by the corresponding national population in 2014. The Chinese population in 2000 and Segi's world population were used to calculate age-standardized rates of colorectal cancer in China. Results: Overall, 370,400 new colorectal cancer cases and 179,600 deaths were estimated in China in 2014, with about 214,100 new cases in men and 156,300 in women. Meanwhile, 104,000 deaths cases of colorectal cancer were men and 75,600 deaths were women, which accounted for 9.74％ and 7.82％ of all cancer incidence and deaths in China, separately. Relatively higher incidence and mortality was observed in urban areas of China. And the Eastern areas of China showed the highest incidence and mortality. The age-standardized incidence and mortality rate of colorectal cancer has increased by about 1.9％ per year for incidence and about 0.9％ per year for mortality rate from 2000 to 2014. Conclusion: With gradually higher incidence and mortality rate in the past 15 years, colorectal cancer became a major challenge to China's public health. Effective control strategies are needed in China.

Background: Chicken anemia virus (CAV) causes chicken infectious anemia, which results in immunosuppression; the virus has spread widely in chicken flocks in China. Objectives: The aim of this study was to understand recent CAV genetic evolution in chicken flocks in Guangxi Province, southern China. Methods: In total, 350 liver samples were collected from eight commercial broiler chicken farms in Guangxi Province in southern China from 2018 to 2020. CAV was detected by conventional PCR, and twenty CAV complete genomes were amplified and used for the phylogenetic analysis and recombination analysis. Results: The overall CAV-positive rate was 17.1%. The genetic analysis revealed that 84 CAVs were distributed in groups A, B, C (subgroups C1-C3) and D. In total, 30 of 47 Chinese CAV sequences from 2005-2020 belong to subgroup C3, including 15 CAVs from this study. There were some specific mutation sites among the intergenotypes in the VP1 protein. The amino acids at position 394Q in the VP1 protein of 20 CAV strains were consistent with the characteristics of a highly pathogenic strain. GX1904B was a putative recombinant. Conclusions Subgroup C3 was the dominant genotype in Guangxi Province from 2018–2020.The 20 CAV strains in this study might be virulent according to the amino acid residue analysis. These data help improve our understanding of the epidemiological trends of CAV in southern China.

Objective: To analyze the incidence trend and mean age at diagnosis for lung cancer in cancer registration areas of China from 2000 to 2014. Methods: The data of lung cancer incidence used in this study were from 22 registries submitted to National Central Cancer Registry with continuous data during 2000 and 2014, covering about 621 593 469 person-years. All cancer cases were coded as C33-C34 according to the International Classification of Diseases-10^th Revision (ICD-10) were extracted for this analysis with about 343 663 patients. The incidence of different sex and regional population, the standardized incidence rate by Chinese population, the average annual change percentage (AAPC), the mean age and adjusted mean age of cancer incidence were calculated. The incidence of each year was described by regional and age groups, and the linear regression model was employed to analyze the relationship between mean age at onset and year. Results: The crude incidence rate and age-standardized incidence rate (ASR) of lung cancer for men in cancer registry areas in 2000 were 56.98 per 100 000 and 48.43 per 100 000, respectively. The rates were 89.51 per 100 000 and 46.85 per 100 000 in 2014, respectively. For women in the same areas, the rates were 27.77 per 100 000 and 20.17 per 100 000 in 2000; while 51.31 per 100 000 and 25.44 per 100 000 in 2014, respectively. The crude incidence rate increased along with the age. In 2000-2014, the trend of crude rate and ASR of lung cancer were significantly increased (CR: AAPC=3.8%, 95%CI: 3.5%-4.1%; ASR: AAPC=0.4%, 95%CI: 0.2%-0.7%). The rise of crude rate in females was higher than that in males (Male: AAPC=3.5%, 95%CI: 3.2%-3.7%; Female: AAPC=4.5%, 95%CI: 4.1%-5.0%). However, the rise of the ASR declined for both male and female (Male: AAPC=-0.2%, 95%CI:-0.4%-0.0%; Female: AAPC=1.4%, 95%CI: 1.0%-1.9%). The average age at diagnosis of lung cancer in rural areas was 64.35 years old in 2000, and increased to 65.97 years old in 2014 (β=0.11, P<0.001), while adjusted mean age at onset remained stable in all areas and urban areas (P>0.05). And the average age at onset increased significantly over time in male (β=-0.02, P=0.014), which was not seen in female (β=-0.01, P=0.522). Conclusion The crude incidence rate of lung cancer in cancer registry areas in China increased slowly during 2000-2014; and the standardized average age of male at diagnosis decreased slightly, while the age in rural areas increased during 2000-2014. Lung cancer will still be the focus of cancer prevention and control in the near future.

Objective: To analyze the trend of cancer incidence and age changes among men in cancer registration areas of China from 2000 and 2014. Methods: We select the information of national cancer registry with continuous data from 2000 to 2014, review and organize the monitoring data at the above registries. A total of 22 monitoring registries were included in this study. The covering population of male were about 314 330 648 person years. The information on the incidence of all male prostate cancer patients with C61 was extracted from the International Classification of Diseases-10^th Revision (ICD-10). To understand the incidence of male prostate cancer in each year, the age-standardized rate by Chinese population (ASR), average annual percent change (AAPC), adjusted mean age at onset were calculated. Incidence rates stratified by regions and age groups were also calculated. The linear regression model was employed to analyze the relationship between mean age at onset and year. Results: The prostate cancer incidence in China increased by 11.5% (95%CI: 10.3%-12.7%) from 2000(4.62/100 000) to 2014(21.62/100 000), the age-standardized incidence rate increased by 7.1% (95%CI: 6.0%-8.1%) and the growth of rural was greater than that of urban. The age-specific incidence showed that the incidence rate increased significantly among the age group of 50 years; the incidence rates in men who have the same age but with different birth years showed a significant increase as birth years increased. The adjusted mean age at diagnosis of prostate cancer in cancer registry areas was 74.09 years old in the year of 2000, reduced by 0.13 year old to 72.35 years old in 2014 (β=-0.13, P<0.001). The adjusted mean age at onset declined significantly over time in urban areas (β=-0.13, P<0.001). Conclusion The trend of prostate cancer incidence among men in cancer registry regions generally increased, and the average age at diagnosis declined slightly from 2000 to 2014.

Objective To investigate the serum levels of dickkopf-related protein 1 (DKK1) and sclerostin (SOST) in patients with axial spondyloarthritis treated with selective cyclo-oxygenase 2 inhibitor and its relation to clinical efficacy.Methods A randomized double-blind controlled trial with axial spondyloarthritis (ax-SpA) was carried out in our hospital.The data from patients in a single center was collected and analyzed.Serum DKK1 and SOST levels were measured by enzyme-linked immuno sorbent assay (ELISA)method before and after 12 weeks treatment,then correlation analysis were conducted for DKK1 and SOST levels with erythrocyte sedimentation rate (ESR),C reactive protein (CRP),Bath ankylosing spondylitis disease activity index (BASDAI),Bath ankylosing spondylitis functional index (BASFI) and SPARCC of the sacroiliac joint inflammation score.Chi-square tests were used for analyzing of categorical data.Fisher exact tests were performed when the expected frequencies were less than 5.Two independent samples t-test was used to compare the difference between groups.Single sample t-test was used to ompare the differences between data before and after treatment.Pearson or Spearman correlation was used for correlation analysis.Results After 12 weeks of treatment,a total of 116 patients completed the follow-up,including 57 cases of imrecoxib group and 59 cases of the celecoxib group.There were no statistically significant difference between the two groups (P＞0.05).The level of serum DKK1 was significantly increased after treatment [(393±137) pg/ml,vs (542±274)pg/ml,P＜0.05].The serum level of SOST increased significantly [(39±19) pg/ml vs (57±36) pg/ml,t=5.814,P＞0.05],too.The difference between the two groups was not statistically significant (P＞0.05).Spearman correlation analysis showed that serum DKK1 was positively correlated with serum SOST (r=0.226,P=0.015).A significantcorrelation was found between SOST level and ESR,CRP,finger to floor distance,left and fight lumbar side flexion and Schober's test (ESR:r=-0.379,P＜0.01;r=-0.309,P=0.001;r=-0.225,P=0.015;r=0.185,P=0.047;r=0.247,P=0.008;r=0.214,P=0.021).Conclusion Imrecoxib and celecoxib have similar efficacy on relieving the signs and symptoms of patients with ax-SpA.Short-term application of selective COX-2 inhibitors can increase DKK1 and SOST and possibly delay radiographic progression.

Objective: To estimate the incidence trend and change in the age distribution of female breast cancer in cancer registry areas in China from 2000 to 2014. Methods: 22 cancer registries in China with continuous monitoring data from 2000 to 2014 were selected. All datasets were checked and evaluated based on data quality control criteria and were included in the analysis. The cancer registries covered 675 954 193 person-years, including 342 010 930 person-years of male and 333 943 263 person-years of female. Female breast cancer cases (International Classification of Diseases-10^th Revision: C50) were extracted. Crude incidence rate (CR), age-standardized incidence rate by Chinese standard population(ASIRC), annual percent change (APC), crude and adjusted mean age at onset were calculated. Incidence rates stratified by regions and age groups were calculated. Results: Female breast cancer incidence rate significantly increased from 31.90/100 000 in 2000 to 63.30/100 000 in 2014. Incidence rate increased rapidly from 2000 to 2008 (CR: APC=6.5%, 95%CI: 5.3%-7.8%; ASIRC: APC=4.6%, 95%CI: 3.6%-5.7%). Its increment slowed down from 2008-2014 (CR: APC=3.2%, 95%CI: 1.4%-5.1%; ASIRC: APC=1.4%, 95%CI:-0.1%-2.9%). The crude mean age at onset increased from 54.4 in 2000 to 57.0 in 2014. Adjusted mean age at onset remained around 54.3 in 2014. Crude mean age at onset increased significantly over time in all registry areas (β=0.192, P<0.001), urban (β=0.205, P<0.001) and rural (β=0.092, P=0.014) areas, while adjusted mean age at onset remained stable in all registry areas (β=0.009, P=0.289), urban (β=0.017, P=0.139) and rural (β=-0.054, P=0.109) areas. Conclusion Female breast cancer incidence rate in China increased from 2000 to 2014. Aging of the population resulted in a significant increase in crude mean age at onset. After age adjustment, no significant changes in age distribution were found.